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Matos MS, da Silva MCAT, Brito MB, Gonçalves AK. Clinical and uterine cervix characteristics of women with Mycoplasma and Ureaplasma in genital discharge. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e20240045. [PMID: 39045962 PMCID: PMC11288264 DOI: 10.1590/1806-9282.20240045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 03/02/2024] [Indexed: 07/25/2024]
Abstract
OBJECTIVE The objective of this study was to assess the clinical and uterine cervix characteristics of patients displaying vaginal discharge with positive results for Mycoplasma sp. and/or Ureaplasma spp. METHODS An analytical cross-sectional study involving women aged 18-45 years was conducted. Microbiological assessments included Ureaplasma and Mycoplasma cultures, as well as human papillomavirus hybrid capture using ecto and endocervix swabs. All tests were two-tailed, and significance was set at p<0.05. RESULTS Among 324 women, Ureaplasma prevalence was 17.9%, and Mycoplasma prevalence was 3.1%. The Ureaplasma-positive group exhibited a higher frequency of urinary tract infections (39.1 vs. 19%, p=0.002) and human papillomavirus (39.7 vs. 12.8%, p≤0.001) compared with controls. The Mycoplasma-positive group showed a higher frequency of non-contraceptive use compared with controls (66.2 vs. 30.0%, p=0.036). Abnormal colposcopic findings were more prevalent in the Mycoplasma/Ureaplasma-positive group than in controls (positive: 65% vs. control: 35%, p=0.001). Pap smear findings did not differ between the groups. CONCLUSION Ureaplasma spp. was associated with urinary tract infections and human papillomavirus, while the presence of Mycoplasma sp. was linked to reduced contraceptive use. When analyzing both pathogens together, a higher frequency of abnormal colposcopic findings was observed, with no difference in cytological findings in the positive group.
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Affiliation(s)
- Margarida Santos Matos
- Bahiana School of Medicine and Public Health, Department of Women's Health – Salvador (BA), Brazil
- Universidade Federal da Bahia, School of Medicine of Bahia, Department of Gynecology and Obstetrics – Salvador (BA), Brazil
| | | | - Milena Bastos Brito
- Bahiana School of Medicine and Public Health, Department of Women's Health – Salvador (BA), Brazil
- Universidade Federal da Bahia, School of Medicine of Bahia, Department of Gynecology and Obstetrics – Salvador (BA), Brazil
| | - Ana Katherine Gonçalves
- Universidade Federal do Rio Grande do Norte, Postgraduate Program in Health Sciences – Natal (RN), Brazil
- Universidade Federal do Rio Grande do Norte, Postgraduate Program in Applied Sciences to Women's Health – Natal (RN), Brazil
- Universidade Federal do Rio Grande do Norte, Department of Gynecology and Obstetrics – Natal (RN), Brazil
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Rossi LH, Gonthier H, Le Gallo A, Baccino E, Jousset N, Peyron PA. Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections among sexual assault victims referred to three French clinical forensic units. Forensic Sci Int 2024; 360:112070. [PMID: 38810590 DOI: 10.1016/j.forsciint.2024.112070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 05/01/2024] [Accepted: 05/23/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections are the most common bacterial sexually transmitted infections (STIs) worldwide. These STIs are frequently asymptomatic, which often delays diagnosis and treatment with the risk of serious long-term complications. Current French recommendations call for targeted screening of populations considered to be at risk, including victims of sexual assault. However, no recent data on the prevalence of these STIs in this population are available in France. The aim of this study was therefore to determine the prevalence of CT/NG infections among victims of sexual assault attending three Clinical Forensic Units (CFUs). METHODS We retrospectively reviewed the forensic records of patients aged over 12 years reporting a sexual assault and referred between January 1, 2020 and December 31, 2021 to the CFU of Montpellier, Angers or Saint-Denis de La Réunion. Patients who had been screened for CT and NG infections were included. RESULTS 341 alleged victims of sexual assault (324 women, 17 men, median age = 23 years) were screened for CT/NG STIs during the inclusion period (Montpellier, n=196; Angers, n=63; Saint-Denis, n=82). The median time between the sexual assault and the examination was 1 day. CT and NG were detected in 28 patients (8.2 %) and 8 patients (2.3 %) respectively, with no men tested positive. Positive results concerned genital samples, except for two CT-positive anorectal samples and one NG-positive oropharyngeal sample. Two patients (0.6 %) were co-infected with CT/NG. The overall prevalence of CT/NG STIs was 10.0 % and was higher in the 18-24 age group, reaching 13.2 % for CT. CONCLUSIONS This multicenter study confirms the high prevalence of CT/NG STIs in victims of sexual assault, and the vulnerability of the youngest age groups to these infections. Systematic screening for CT/NG STIs at the time of the forensic examination is the key to early diagnosis and effective treatment to prevent transmission and subsequent complications in these patients.
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Affiliation(s)
- Léa-Héléna Rossi
- Service de Médecine Légale et Pénitentiaire, CHU d'Angers, Université d'Angers, Angers, France
| | - Hélène Gonthier
- Service de Médecine Légale, APHM, Hôpital de la Timone, Marseille, France
| | - Arnaud Le Gallo
- Institut de Médecine Légale et Pénitentiaire, CHU de la Réunion, Saint-Denis, France
| | - Eric Baccino
- Département de Médecine Légale, CHU de Montpellier, Université de Montpellier, Montpellier, France; EDPFM, UR-UM212, Université de Montpellier, Montpellier, France
| | - Nathalie Jousset
- Service de Médecine Légale et Pénitentiaire, CHU d'Angers, Université d'Angers, Angers, France
| | - Pierre-Antoine Peyron
- Département de Médecine Légale, CHU de Montpellier, Université de Montpellier, Montpellier, France.
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Yesodharan R, Kamath P, Renjith V, Krishnan NM, Senarathne UD, Sasidharan SK, Jose TT, Nayak VC. The role of legal medicine professionals in preventing pregnancy and sexually transmitted infections among female victims of sexual assault. Forensic Sci Med Pathol 2023; 19:440-451. [PMID: 36881378 PMCID: PMC10518277 DOI: 10.1007/s12024-023-00578-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2023] [Indexed: 03/08/2023]
Abstract
Sexual violence can have an overwhelming impact on the victim's physical and mental health; the consequences include unintended pregnancy and sexually transmitted infections (STIs). Therefore, the examiners must assess victims for possible pregnancy and sexually transmitted infections as a part of the sexual assault examination. This article aims to orient the medico-legal examiners towards their role in preventing unintended pregnancy and sexually transmitted infections among victims of sexual assault. Prompt detection of pregnancy or STIs is critical, as any delay would adversely affect the successful administration of emergency contraception and post-exposure prophylaxis (PEP) against human immunodeficiency virus (HIV) and other sexually transmitted infections.
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Affiliation(s)
- Renjulal Yesodharan
- Department of Psychiatric Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka India
| | - Pratibha Kamath
- Department of OBG Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka India
| | - Vishnu Renjith
- School of Nursing & Midwifery, Royal College of Surgeons in Ireland, 123 St Stephen’s Green, Dublin 2, Ireland
| | - Nirmal M. Krishnan
- Department of Forensic Medicine and Toxicology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka India
| | - Udara Dilrukshi Senarathne
- Faculty of Medical Sciences, Department of Biochemistry, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Suja Kumari Sasidharan
- Department of Obstetrics and Gynaecological Nursing, Amrita College of Nursing, Amrita Vishwa Vidyapeetham, Ernakulum, Kerala India
| | - Tessy Treesa Jose
- Department of Psychiatric Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka India
| | - Vinod C. Nayak
- Department of Forensic Medicine and Toxicology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka India
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Ortega-López-Peláez M, Sánchez-Pastor-Ruiz M, Quiles-Melero I. Sexually transmitted infections among victims reporting sexual assaults attending at Hospital La Paz, Madrid (Spain). ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2023; 41:54-55. [PMID: 36175286 DOI: 10.1016/j.eimce.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/27/2022] [Accepted: 02/01/2022] [Indexed: 01/11/2023]
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Skjælaaen K, Nesvold H, Brekke M, Sare M, Landaas ET, Mdala I, Olsen AO, Vallersnes OM. Sexually transmitted infections among patients attending a sexual assault centre: a cohort study from Oslo, Norway. BMJ Open 2022; 12:e064934. [PMID: 36456026 PMCID: PMC9716778 DOI: 10.1136/bmjopen-2022-064934] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES We estimate the prevalence of sexually transmitted infection (STI) among patients after sexual assault, assess the possible value of azithromycin prophylaxis, and identify risk factors for assault-related STI and for not presenting at follow-up. DESIGN Prospective observational cohort study. SETTING Sexual assault centre in Oslo, Norway. PARTICIPANTS 645 patients, 602 (93.3%) women and 43 (6.7%) men, attending the centre from May 2017 to July 2019. OUTCOME MEASURES Microbiological testing at the primary examination and at follow-up consultations after 2, 5 and 12 weeks. Estimated relative risk for assault-related STI and for not presenting at follow-up. RESULTS At primary examination, the prevalence of genital chlamydia was 8.4%, Mycoplasma genitalium 6.4% and gonorrhoea 0.6%. In addition, the prevalence of bacterial STI diagnosed at follow-up and possibly from the assault was 3.0% in total: 2.5% for M. genitalium, 1.4% for genital chlamydia and 0.2% for gonorrhoea. This prevalence did not change when azithromycin was no longer recommended from January 2018. There were no new cases of hepatitis B, hepatitis C, HIV or syphilis. We found no specific risk factors for assault-related STI. Patients with previous contact with child welfare service less often presented to follow-up (relative risk (RR) 2.0 (95% CI 1.1 to 3.5)), as did patients with a history of sex work (RR 3.6 (1.2 to 11.0)) or substance abuse (RR 1.7 (1.1 to 2.7)). CONCLUSIONS Most bacterial STIs were diagnosed at the primary examination, hence not influenced by prophylaxis. There was no increase in bacterial STI diagnosed at follow-up when azithromycin prophylaxis was not routinely recommended, supporting a strategy of starting treatment only when infection is diagnosed or when the patient is considered at high risk. Sex work, substance abuse and previous contact with child welfare services were associated with not presenting to follow-up. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT03132389).
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Affiliation(s)
- Katarina Skjælaaen
- Department of General Practice, University of Oslo, Oslo, Norway
- Oslo Sexual Assault Centre, City of Oslo Health Agency, Oslo, Norway
| | - Helle Nesvold
- Oslo Sexual Assault Centre, City of Oslo Health Agency, Oslo, Norway
| | - Mette Brekke
- Department of General Practice, University of Oslo, Oslo, Norway
| | - Miriam Sare
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Elisabeth Toverud Landaas
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ibrahimu Mdala
- Department of General Practice, University of Oslo, Oslo, Norway
| | - Anne Olaug Olsen
- Department of Community Medicine and Global Health, University of Oslo, Oslo, Norway
- Department of Infection Control and Vaccine, Norwegian Institute of Public Health, Oslo, Norway
| | - Odd Martin Vallersnes
- Department of General Practice, University of Oslo, Oslo, Norway
- Oslo Accident and Emergency Outpatient Clinic, City of Oslo Health Agency, Oslo, Norway
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Ortega-López-Peláez M, Sánchez-Pastor-Ruiz M, Quiles-Melero I. Infecciones de transmisión sexual en víctimas de agresiones/abusos sexuales atendidas en el Hospital La Paz, Madrid (España). Enferm Infecc Microbiol Clin 2022. [DOI: 10.1016/j.eimc.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Seidu AA, Ahinkorah BO, Dadzie LK, Tetteh JK, Agbaglo E, Okyere J, Salihu T, Oteng KF, Bugase E, Osei SA, Hagan JE, Schack T. A multi-country cross-sectional study of self-reported sexually transmitted infections among sexually active men in sub-Saharan Africa. BMC Public Health 2020; 20:1884. [PMID: 33287785 PMCID: PMC7722450 DOI: 10.1186/s12889-020-09996-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 12/01/2020] [Indexed: 12/18/2022] Open
Abstract
Background Despite the importance of self-reporting health in sexually transmitted infections (STIs) control, studies on self-reported sexually transmitted infections (SR-STIs) are scanty, especially in sub-Saharan Africa (SSA). This study assessed the prevalence and factors associated with SR-STIs among sexually active men (SAM) in SSA. Methods Analysis was done based on the current Demographic and Health Survey of 27 countries in SSA conducted between 2010 and 2018. A total of 130,916 SAM were included in the analysis. The outcome variable was SR-STI. Descriptive and inferential statistics were performed with a statistical significance set at p < 0.05. Results On the average, the prevalence of STIs among SAM in SSA was 3.8%, which ranged from 13.5% in Liberia to 0.4% in Niger. Sexually-active men aged 25–34 (AOR = 1.77, CI:1.6–1.95) were more likely to report STIs, compared to those aged 45 or more years. Respondents who were working (AOR = 1.24, CI: 1.12–1.38) and those who had their first sex at ages below 20 (AOR = 1.20, CI:1.11–1.29) were more likely to report STIs, compared to those who were not working and those who had their first sex when they were 20 years and above. Also, SAM who were not using condom had higher odds of STIs (AOR = 1.35, CI: 1.25–1.46), compared to those who were using condom. Further, SAM with no comprehensive HIV and AIDS knowledge had higher odds (AOR = 1.43, CI: 1.08–1.22) of STIs, compared to those who reported to have HIV/AIDS knowledge. Conversely, the odds of reporting STIs was lower among residents of rural areas (AOR = 0.93, CI: 0.88–0.99) compared to their counterparts in urban areas, respondents who had no other sexual partner (AOR = 0.32, CI: 0.29–0.35) compared to those who had 2 or more sexual partners excluding their spouses, those who reported not paying for sex (AOR = 0.55, CI: 0.51–0.59) compared to those who paid for sex, and those who did not read newspapers (AOR = 0.93, CI: 0.86–0.99) compared to those who read. Conclusion STIs prevalence across the selected countries in SSA showed distinct cross-country variations. Current findings suggest that STIs intervention priorities must be given across countries with high prevalence. Several socio-demographic factors predicted SR-STIs. To reduce the prevalence of STIs among SAM in SSA, it is prudent to take these factors (e.g., age, condom use, employment status, HIV/AIDS knowledge) into consideration when planning health education and STIs prevention strategies among SAM.
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Affiliation(s)
- Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana. .,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - Louis Kobina Dadzie
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Justice Kanor Tetteh
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Ebenezer Agbaglo
- Department of English, University of Cape Coast, Cape Coast, Ghana
| | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Tarif Salihu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Kenneth Fosu Oteng
- Ashanti Regional Health Directorate, Ghana Health Service, Kumasi, Ghana
| | - Eustace Bugase
- Department of Health Policy Planning and Management, School of Public Health, University of Ghana, Accra, Ghana
| | - Sampson Aboagye Osei
- Department of Geography and Regional Planning, University of Cape Coast, Cape Coast, Ghana
| | - John Elvis Hagan
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana.,Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany
| | - Thomas Schack
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany
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